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Case Reports
. 2010 Oct 5:2011:563216.
doi: 10.4061/2011/563216.

Immunophenotypical Switch versus Tumor Heterogeneity in a Patient with HIV-Associated Diffuse Large B-Cell Lymphoma

Jorge J Castillo  1 , Tina Rizack, Diana Treaba
Affiliations
Case Reports

Immunophenotypical Switch versus Tumor Heterogeneity in a Patient with HIV-Associated Diffuse Large B-Cell Lymphoma

Jorge J Castillo et al. Patholog Res Int. .

Abstract

Patients with HIV/AIDS have a higher risk of developing aggressive B-cell lymphomas, such as diffuse large B-cell lymphoma (DLBCL). Lymphomas are rather heterogeneous in nature and in a few cases can switch their genetic or immunohistochemical phenotype, transform into other lymphomas or carry more than one malignant clone. In this report, we present the case of a 47-year-old man with HIV infection who was diagnosed with an apparent low-risk, early-stage DLBCL, but became refractory to therapy while undergoing treatment with rituximab-containing chemotherapy. We postulate that the development of his refractory disease occurred in the context of an immunohistochemical switch or the surge of a clone refractory to therapy. This phenomenon was not associated with a superinfection with EBV or HHV-8.

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Figures

Figure 1
Figure 1
CD20-positive diffuse large B-cell lymphoma with a germinal center immunophenotypical profile (initial excisional biopsy).
Figure 2
Figure 2
CD20-negative diffuse large B-cell lymphoma with a nongerminal center immunophenotypical profile (second excisional biopsy).
See this image and copyright information in PMC

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